The Effect of Digital Team-based Communication on Patient-initiated Telephone Contacts to Hospital After Discharge

The Effect of Digital Team-based Communication Between Orthopaedic Surgery Patients and Healthcare Professionals on Patient-initiated Telephone Contacts to Hospital After Discharge: a Randomized Controlled Trial

The aim of this study is to investigate the effects of eDialogue versus standard communication pathways on patient-initiated telephone contacts to the hospital following discharge. Secondary aims are to explore the effect on other patient-initiated contacts after hospital discharge (mail, video, SMS, personal attendance) and, if digital team-based communication can positively affect patients experience of continuity of care.

Transition of care from hospital to home following orthopaedic surgery pose a significant risk to patient safety. After discharge, patients or primary care providers may need to communicate with the specialized healthcare team at the hospital about symptoms, postoperative complications, rehabilitation, wounds and medication, but are hampered by a fragmented healthcare system with slow communication pathways. Communication through phone often involves several intermediaries and waiting time for both patients and healthcare professionals. The fact that patients and healthcare professionals must be present at the same time is inflexible and disruptive to work processes. However, cross-sectoral communication and collaboration with patients after hospital discharge are prerequisites to achieve high-quality care and good patient outcomes. Review of the literature show that few studies have explored the effects of digital team-based communication with the patient and across sectors to facilitate collaboration and knowledge sharing after discharge. On the basis of findings from a preliminary pilot study suggesting asynchronous digital team-based communication between orthopaedic surgery patients and healthcare professionals across sectors (eDialogue) may be a solution to the existing problems in communication pathways, we initiated this trial.

Patients are recruited from the following orthopaedic surgery sub-specialties at Aalborg University Hospital:

• Deformity surgery
• Trauma surgery, including fractures of the spine

Inclusion Criteria:

Patients admitted and operated at Aalborg University Hospital, who;

• have complex care needs involving cross disciplinary and cross sectoral care after hospital discharge
• will be discharged to their home
• will need follow-up in the outpatient clinic after discharge

Patients at all ages, but:

• if patient is < 15 years old, the parent(s) will be included in the study as user(s) of LetDialog.
• if patient is 15-18 years old, the patient will be the user in LetDialog and answer the questionnaires to comply with existing Danish legislation Health Act § 17. If the patient wishes, parent(s) can be included as user(s) in LetDialog as well.

Have access to and ability to use a smartphone Have access to NemID (needed to create a GDPR-safe user profile in LetDialog)

Exclusion Criteria:

Patients, who:

• have previously participated in the eDialogue pilot study
• are discharged to a rehabilitation center, nursing home or similar
• do not speak/read Danish or English well enough to understand participant information and use digital communication in Danish or English through LetDialog
• are included in other ongoing randomized controlled trials or prospective follow-up studies in the Orthopaedic Surgery Department at Aalborg University Hospital, where participation could possibly affect the results of these studies